Association of exfoliation syndrome and central retinal vein occlusion: an ultrastructural analysis

Ritch, Robert; Prata, Tiago S.; Moraes, Carlos Gustavo V. De; Vessani, Roberto Murad; Costa, Vital Paulino; Konstas, Anastasios G. P.; Liebmann, Jeffrey M.; Schlötzer‐Schrehardt, Ursula

doi:10.1111/j.1755-3768.2009.01578.x

Cited by 53 publications

(41 citation statements)

References 42 publications

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“…28,[30][31][32] We have recently investigated the presence of XFS in 36 CRVO eyes using electron microscopy, and a clinical diagnosis or a positive conjunctival biopsy result was found in 22 eyes. 33 We hypothesised that the connection between XFS and RVO might depend on the extent of involvement of an eye by XFS. The findings of this study corroborate this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Prata

Rozenbaum

Moraes

et al. 2009

Eye

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Purpose To evaluate the relationship between retinal vascular occlusions (RVOs) and exfoliation syndrome (XFS) in a cohort of patients with the two conditions. Methods We reviewed the records of patients with XFS with or without glaucoma and any type of RVO between 1983 and 2007. Patients with prior incisional surgery or a history of uveitis were excluded. Data collected included demographics, systemic comorbidities, type of RVO, and intraocular pressure (IOP) before the RVO. Slit-lamp biomicroscopy regarding the presence of exfoliation material on the lens capsule and pupillary margin before the vascular event was used to evaluate the laterality and degree of XFS. Results We identified 36 patients (mean age 78.4±8.3 years, 19 women). Most patients were of European descent (34/36) and 20 (56%) had no prior glaucoma diagnosis. The most common retinal vascular events were central retinal vein occlusion (18/36) and BRVO (10/36). Mean IOP between eyes with (19.5 ± 6.5 mm Hg) and without (17.9 ± 4.8 mm Hg) RVO was similar (P ¼ 0.12). RVOs occurred more commonly in the eye with more pronounced XFS in 92% (33/36) of the cases. A similar agreement was found when considering patients with and without glaucoma separately (94% (15/16) vs 90% (18/20); P ¼ 0.83). In addition, no difference in the agreement percentage was observed when comparing patients with unilateral XFS (87% (13/15)) with all study patients (P ¼ 0.87). Conclusions Retinal vascular occlusion in patients with XFS occurs most often in the affected or more severely affected eye.As vascular occlusions happened in patients with and without glaucoma in similar proportions, the presence of XFS seems to play an important role in these findings.

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Section: Discussionmentioning

confidence: 99%

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Prata

Rozenbaum

Moraes

et al. 2009

Eye

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“…12 Central retinal vein occlusions occur more commonly in XFS vs controls. 13,14 Systemically, vascular changes include a lower ankle brachial index in XFS vs controls, which suggests an accompanying peripheral vascular disease in XFS. 15 Fingertip cutaneous capillary blood flow measured by laser Doppler flowmetry is lower in XFG compared with POAG and controls and the duration of cold-induced blood flow reduction as well as recovery periods are longer in XFG compared with POAG and controls.…”

Section: Introductionmentioning

confidence: 99%

Nailfold capillary morphology in exfoliation syndrome

Cousins

Kang

Bovee

et al. 2017

Eye

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Purpose The purpose of the study was to investigate nailfold microvascular morphology in exfoliation syndrome with or without glaucoma (XFS/XFG) compared with primary open-angle glaucoma (POAG) and control subjects using nailfold capillary videomicroscopy. Patients and methods We used a JH-1004 capillaroscope to perform nailfold capillary videomicroscopy on the fourth and fifth digit of the non-dominant hand. We enrolled 56 XFS/XFG patients, 87 POAG patients, and 75 control subjects. Masked observers graded the videos for hemorrhages, avascular zones ≥ 200 microns (μm), and degree of microvascular tortuosity on a four-point subjective scale. Multivariable odds ratios, 95% confidence intervals and P-for trends for assessing the relation between morphological changes and POAG or XFS/XFG were obtained from logistic regression analyses. We also assessed this relation with XFS/XFG compared with POAG in multivariable models. Results After adjusting for multiple covariates, nailfold hemorrhages, avascular zones ≥ 200 μm, and higher degree of vascular tortuosity were more common in XFS/XFG vs controls (P-for trend ≤ 0.0001) and in POAG vs controls (P-for trend ≤ 0.01). For each 100 capillaries, the number of hemorrhages was similar (P-for trend = 0.91) between XFS/XFG and POAG patients; however, there were more avascular zones per 100 capillaries with borderline significance (P-for trend = 0.04) in the XFS/XFG group. XFS/XFG patients had more tortuosity than POAG patients; specifically, having a tortuosity score ≥ 1.5 was associated with a 4.4-fold increased odds of XFS/XFG (95% confidence interval: 1.5-13.3) relative to a tortuosity score o1.0 (P-for trend = 0.005). Conclusion A high degree of nailfold capillary tortuosity is a distinct non-ocular feature associated with XFS/XFG compared with either POAG or controls.

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“…Due to the unique nature of NVG, which is known to be a result of CRVO rather than the cause, especially in the ischemic type [3, 9], we analyzed both groups after excluding NVG. We found that RVO was significantly more prevalent in the PXF group ( p = 0.003).…”

Section: Discussionmentioning

confidence: 99%

“…The PXF syndrome is known as a major risk factor for the development of glaucoma and is often associated with severe, refractory disease [2, 3, 7]. An association between CRVO and PXF has been shown in some studies, but up to date, it has not yet been proven whether the association between PXF and RVO is by the glaucoma mediator or whether PXF is an independent risk factor for RVO [8, 9].…”

Section: Introductionmentioning

confidence: 99%

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The Incidence of Retinal Vein Occlusion in Patients with Pseudoexfoliation Glaucoma: A Retrospective Cohort Study

et al. 2018

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Purpose: The aim of this study was to evaluate pseudoexfoliation (PXF) as an independent risk factor for the occurrence of retinal vein occlusion (RVO). Methods: This is a retrospective cohort study on the records of 300 PXF glaucoma patients (PXF group), 300 non-PXF glaucoma patients, and 599 nonglaucoma non-PXF (nGnP group) patients. Results: Multivariate analysis resulted in a significant probability for RVO in the PXF (p = 0.005; OR 2.29 [1.13–4.68]) and non-PXF glaucoma groups (p = 0.005; OR 3.03 [1.55–5.94]) compared to the nGnP group. There was a much higher probability for central RVO (CRVO) in the PXF (p = 0.013; OR 3.64 [1.39–9.49]) and non-PXF glaucoma groups (p = 0.013; OR 3.78 [1.48–9.65]) compared to the nGnP group. After matching and excluding neovascular glaucoma, no significant difference was found between the PXF and non-PXF glaucoma groups regarding RVO (p = 0.541), CRVO (p = 0.092), and branch RVO (p = 0.774). Conclusions: PXF and other types of glaucoma are associated with RVOs, mainly CRVO. PXF was not found to be an independent risk factor for CRVO.

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Association of exfoliation syndrome and central retinal vein occlusion: an ultrastructural analysis

Cited by 53 publications

References 42 publications

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Nailfold capillary morphology in exfoliation syndrome

The Incidence of Retinal Vein Occlusion in Patients with Pseudoexfoliation Glaucoma: A Retrospective Cohort Study

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